Session: A Mixed-Methods Study of a Statewide Involuntary Outpatient Commitment Program (Society for Social Work and Research 22nd Annual Conference - Achieving Equal Opportunity, Equity, and Justice)

Involuntary outpatient commitment (IOC) is a controversial mechanism within mental health law and policy. Individuals who meet state-specified criteria for dangerousness to self or others within the foreseeable future are court ordered to receive outpatient treatment under an IOC order. While less restrictive than civilly committed inpatient treatment, IOC is opposed by many advocates and organizations because it concentrates resources on individuals who are opposed to or ambivalent about treatment instead of on voluntary treatment seekers who may as a result experience treatment delays. In addition, many mental health advocates oppose IOC because mandating treatment may undermine treatment motivation and service engagement in the long run.

Research evidence regarding IOC is equivocal and its conclusions disputed by various scholars. Nevertheless, IOC is receiving renewed attention in the US with the recent proposal of the Helping Families in Mental Health Crisis Act (H.R. 2646), which would provide funding to allow states that do not already use IOC to develop programs. Because the implementation of IOC is determined by both state law and local program design, there is an important need to examine implementation within and across programs.

This symposium presents analyses from a newly implemented IOC program across six sites within one state that recently passed new IOC legislation. The mixed-methods evaluation design involved abstraction of program records for all consumers within the first three years of implementation, qualitative interviews with consumers, IOC providers, community treatment providers, family members, and advocates; and the collection of satisfaction measures from a subsample of consumers. In this symposium, we will present several findings from the evaluation: 1) analysis of successful vs. unsuccessful cases and barriers to effective implementation as reported by program providers; 2) examination of referred vs. accepted cases and provider perceptions of appropriate vs. inappropriate referrals; 3) consumer experiences of IOC; and 4) analysis of the role peer providers (i.e. providers with lived experience of mental illness) in the implementation of IOC programs. Together, these papers illuminate and clarify issues related to IOC program design and implementation that should be kept in mind as IOC is increasingly held up by policymakers as a panacea for issues such as violence, criminal justice involvement, and recidivism.